HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONat;-1 24121
Permit Number:
J , /•
• BluLA.in
M Pe t A icli a
r23OO
ing and Development Services
ing and Code Regulation Division Virginia Avenue, Fort Pierce FL 34982
e: (772) 462-1553 Fax: (772) 462-1578 ,Commercial X !Residential
HERMIT AP,&LICATION,LOR: Window/door
Address: 10680 S OCEAN DR 1003, JENSEN BEACH, FL 34957
gal Description:
ISLAND CREST CONDOMINIUM UNIT 1003 AND UNDIV SHARE IN COMMON ELEMENTS
Pro erttyy Tax ID #: 4511-516-0100-000-6 Lot N .
�i a Iaii e. Block No.
sec ame:
411etbacks Front Back.40 0 Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
eep ace 3 win ows an 2 1 Ing g ass cloors w13 h rrl I ct PIRMW 211idir?gI
CONSTRUCTION INFORMATION:
Add
__itional work to be r1ormed under this permit6check all app y: -
�HVAC �as Tank FklGas Piping _ Shutters Q Windows/Doors
ElIMFic ❑m , []S E en r , oof #�oof itc
Total S . Ft of Construction: S . Ft. of Floor:
ost o o tructioi 1,450 ti�s we septic Bull •ig
�m - P- -
OWNER/LESSEE:
CONTRACTOR:
Name Robert T Brown _
Address:63 Blue Ridge DR _
City: Brick State: NJ*
Zip Code: 08724 — Fax:_ _
Phone No. 732-295-8411
E-Mail: Robtelectric@juno.com
Name: Janet Milici
Company: Natural Flow, In
Address: 391 NE Baker Rd.
City: Stuart _ State: F
Zip Code: 34994— Fax: 772-334-1078 40_
Phone No. 772-334-1011 _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)$
E-Mail: Janet@naturalflow.nele
State or County License: SCC 131151263
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/VG,SE Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City: a
Zip: Phone
Address:
City:
Zip: Phone:
S
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable*
Address:
City:
Address:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I c th rk r in as mr�en d pr to ssuance o er it
•p
St. ucle Coun y ma <es no representation that is granting a permit will authorize tI-ie permit TerVtouRitWhesu sect structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit suc
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perfor th r
in accord �yith t ap�ov plas, a Bild gode�s at. LucCo uy �nents
The folio g Ildin permit a plica ion are e em fr m ndergorng a full concurrency review: room a ditrons, -
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing,
with lender or an attorney before commencing work or recording your Notice of Commencement.
Si r�rO)T/RIDA*
/= Lessee/Contractor as Agent for Owner•
STATE
COUNTY OF
Sworn to (or affirmed) and subscribed before me of*
Physical Presence or Online Notarization
Z this "tiay of by _
Name of erson making statement.
Personally Known OR Produced Identification
Type of Identification - _
Produced!
N11 , _.•
(Signature of Not ry r7bli�uState of Florida )
ommisslon o. 150 �' 114S nary Public State of Fl,
:� � gonna Jayne Hall
My Commission GG 207
• - 1t' ❑.,....ems rui i U�n99
1110011 40�4L r.01 •.
� • -
Si natu e of Co ractor/License Holder
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of D[[ 7nl3oe by_
J &Ae__+ rv\
Name of person making statement.
Persona y Know x "Produced en I Ica Ion
Type of Identification_
Produced ,Y
/L � �/ . Mil n
ure of Notaky�lic $t e� a,�otary PuWrcState ot
Z�7 `�j Donna Jayne Hall
�SIOn O. V J 0 • ,`�pmmtssion GG 2
Expires D411512020
EVIEWS • FRONT 0 G UPERVISOR PLANSPVEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW tEVIEW REVIEW OREVIEWM REVIEVAS REVIEVAM
DATE 0 • • • • • • • • • •
RECEIVED _ _
DATE�011I j 0 0 —
�=I, �in
COMPLETED
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